TY  - BOOK
AU  - Lindsay, Joseph
AU  - Sardi, Gabriel L
AU  - Waksman, Ron
TI  - Safety of bivalirudin in percutaneous coronary intervention following thrombolytic therapy
SN  - 1522-1946
PY  - 2013///
KW  - *Antithrombins/tu [Therapeutic Use]
KW  - *Coronary Thrombosis/th [Therapy]
KW  - *Myocardial Infarction/th [Therapy]
KW  - *Peptide Fragments/tu [Therapeutic Use]
KW  - *Percutaneous Coronary Intervention
KW  - *Thrombolytic Therapy
KW  - Adult
KW  - Aged
KW  - Anticoagulants/tu [Therapeutic Use]
KW  - Antithrombins/ae [Adverse Effects]
KW  - Combined Modality Therapy
KW  - Coronary Thrombosis/di [Diagnosis]
KW  - Coronary Thrombosis/mo [Mortality]
KW  - Female
KW  - Hemorrhage/ci [Chemically Induced]
KW  - Heparin/tu [Therapeutic Use]
KW  - Hirudins/ae [Adverse Effects]
KW  - Hospital Mortality
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Myocardial Infarction/di [Diagnosis]
KW  - Myocardial Infarction/mo [Mortality]
KW  - Patient Selection
KW  - Peptide Fragments/ae [Adverse Effects]
KW  - Percutaneous Coronary Intervention/ae [Adverse Effects]
KW  - Percutaneous Coronary Intervention/mo [Mortality]
KW  - Recombinant Proteins/ae [Adverse Effects]
KW  - Recombinant Proteins/tu [Therapeutic Use]
KW  - Recurrence
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Thrombolytic Therapy/ae [Adverse Effects]
KW  - Thrombolytic Therapy/mo [Mortality]
KW  - Time Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
N2  - BACKGROUND: BIV has emerged as a safer anticoagulant than unfractionated heparin (UFH) during primary PCI; however, its use in patients who receive thrombolytic therapy has not been established; CONCLUSIONS: The use of BIV in patients presenting with STEMI who were pretreated with thrombolytic therapy and who subsequently underwent PCI is safe and is associated with less ischemic and bleeding events when compared with UFH, and should be considered as the first line anticoagulant for these patients during PCI. Copyright  2012 Wiley Periodicals, Inc; METHODS: A consecutive series of 104 patients who presented with STEMI treated with full-dose thrombolytics and who subsequently received PCI within 6 hr was identified and analyzed. BIV use was compared with UFH for in-hospital bleeding and ischemic events. The primary end points were the rate of major bleeding and the rate of net adverse clinical events as defined in the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial. The study cohort consisted of 104 patients, of whom 47 (45%) received BIV and 57 (55%) received UFH; OBJECTIVES: This study was undertaken to evaluate the safety of bivalirudin (BIV) use during percutaneous coronary intervention (PCI), following thrombolytic therapy in patients with ST-segment elevation myocardial infarction (STEMI); RESULTS: Patients on BIV were more frequently preloaded with clopidogrel, while intraprocedural glycoprotein IIb/IIIa inhibitors were used only in UFH patients. In-hospital death, ischemic events, and thrombolysis in myocardial infarction major bleeding occurred more frequently in patients treated with UFH. The net adverse clinical events rate was lower in the intraprocedural BIV group (3 [6.4%] vs. 12 [21.1%] UFH, P = 0.034)
UR  - http://dx.doi.org/10.1002/ccd.24478
ER  -